Are you a victim of this “silent killer”? Carbon monoxide could be lurking in your home. According to the American Lung Association, “...Carbon monoxide (CO) is an odorless, colorless, but dangerous gas. It is produced when a fuel such as natural gas, oil, kerosene, wood or charcoal is burned. Exposure to CO reduces the blood's ability to carry oxygen. Fuel-burning appliances used indoors must be maintained, used properly and fully vented to the outdoors to prevent dangerous levels of CO. Hundreds of people die accidentally every year from CO poisoning caused by malfunctioning or improperly used fuel-burning appliances.


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What are the health effects of carbon monoxide?

Yes. Every home should ha

Once inhaled, CO attaches to the hemoglobin in the red blood cells. Hemoglobin normally carries oxygen throughout the body. When CO attaches, it blocks the oxygen the body must have, creating a wide range of health problems.


Breathing low levels of CO can cause: Headache Nausea Dizziness Weakness Confusion Disorientation

Breathing CO at low levels regularly may cause permanent mental or physical problems. At very high levels, it causes loss of consciousness and death.

Approximately 450 people die each year from CO exposure related to fuel-burning, residential appliances. Thousands more became ill or sought medical attention. CO poisoning is estimated to cause more than 50,000 emergency room visits in the United States each year.

How can you protect yourself from carbon monoxide?

Make sure stoves or other devices that burn fuel indoors are fully vented to the outdoors. Have a professional check them once a year to be sure they are running well.

Sources include:

Gas appliances (furnaces, ranges, ovens, water heaters, clothes dryers, etc.) Fireplaces, wood stoves Coal or oil furnaces Space heaters or oil or kerosene heaters Charcoal grills, camp stoves Gas-powered lawn mowers and power tools Automobile exhaust fumes

The following simple steps can prevent CO poisoning:

Make sure appliances are installed and working according to manufacturers’ instructions and local building codes. Never use unvented appliances — make sure all appliances are fully vented to the outdoors. Have the heating system, chimney and flue inspected and cleaned by a qualified technician every year. Do not use ovens and gas ranges to heat your home. Do not burn charcoal, kerosene lanterns or portable camp stoves inside a home, cabin, recreational vehicle or camper. Do not operate gasoline-powered engines in confined areas such as garages or basements. Never leave your car or mower running in a closed garage. Make sure your furnace has an adequate intake of outside air. Install a CO detector with an audible alarm in your home and garage. Cigarettes, pipes and cigars also produce carbon monoxide. Do not let anyone smoke inside your home.

After an emergency or power outage, be sure to remember these steps so you don't risk your family’s health. Too many people are poisoned by CO after bad weather emergencies, like snowstorms and hurricanes. You may need to seek shelter elsewhere until the electricity is back.

Should I buy a carbon monoxide detector?

Yes. Every home should have a working CO detector; it may save your life.


CO detectors should:


Meet Underwriters Laboratories, Inc. standards Have a long-term warranty Be easily self-tested and reset to ensure proper functioning


For maximum effectiveness while you sleep, CO detectors should be placed as close to sleeping areas as possible…” (What is Carbon Monoxide? 2015)


Additionally, Homeowners’ insurance companies generally offer some type of discount to residences that have working smoke and carbon monoxide detectors. (Woollard, n.d.).


So, if you currently engage in any of the activities discussed above, then you are particularly at increased risk of exposure to the harmful and often deadly effects of carbon monoxide poisoning.


Do not:


Use charcoal briquettes indoors for cooking or heating, especially during storm related power outages. Improperly use gasoline –powered generators to provide electricity. Use gasoline-powered pressure washers to cleanup. Allow anyone to smoke cigarettes inside your home

Be sure to read and follow the warning labels on bags of briquettes, as well as fuel powered machinery. For more information contact the Consumer Product Safety Commission (CPSC).


This is just the beginning of the conversation. Please post ideas, and/or tell us about incidents that may have occurred in your community. Let’s talk.


As your Fit For You Environmental Health Correspondent, I urge you to send in questions/stories regarding the environmental health issues that confront you on a daily basis in your local area. Please write, and post questions and/or any concerns that you would like to learn more about here. I promise that I will investigate and discuss at my earliest convenience.


Remember:  What you don’t know can hurt you, today, or sometime in the future- become informed, knowledge is power!


Sources:


What is Carbon Monoxide? (2015). Retrieved February 16, 2015, from http://www.lung.org/healthy-air/home/resources/carbon-monoxide-indoors.html


Notes from the Field: Carbon Monoxide Exposures Reported to Poison Centers and Related to Hurricane Sandy — Northeastern United States, 2012. Retrieved February 16, 2015 from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6144a5.htm


Sen S, Peltz C, Beard J, Zeno B. Recurrent carbon monoxide poisoning from cigarette smoking. Am J Med Sci 2010;340:427–428.


Secondhand cigarette smoke as a cause of chronic carbon monoxide poisoning. Postgrad Med. 1981 Jul ;70(1):77-9.


Woollard, Deidre, (n. d). What Homeowners’ Insurance Discounts Are You Missing? Retrieved from:http://www.realtor.com/advice/what-homeowners-insurance-discounts-are-you-missing


The U.S. Department of Agriculture (USDA) defines a food desert as “…as parts of the country vapid of fresh fruit, vegetables, and other healthful whole foods, usually found in impoverished areas. This is largely due to a lack of grocery stores, farmers' markets, and healthy food providers…” (ANA.org.2010)


The authors of Foodways of the Urban Poor “… data reveals that cost, not lack of knowledge or physical distance, is the primary barrier to healthy food access, and that low-income people employ a wide variety of strategies to obtain the foods they prefer at prices they can afford…(Alkon, etal. 2013)


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Did you know that The First Lady, Mrs. Michele Obama, has spearheaded the “Let’s Move” initiative to end childhood obesity? This program provides development funding to low income communities for startups of grocery stores, farmer’s markets, food Co-Ops, corner stores that facilitate access to healthy and affordable food.


We Americans historically were an agrarian society. Plus, even at the turn of the 20th century, Americans planted individual gardens to supplement their food stock. We did it on a massive scale during wartime and in tough economic times such as the great depression in the 1930s, and even during recession in the early 1970s. Consider the “victory gardens” during World War II. However, as soon as the difficult times ended, we would cease to grow our own produce.


Many of us have farming in our background, either via working on someone else’s farm or working on the family farm as near as two generations ago. However, as we migrated to urban areas, the majority have lost touch with the land.


Why not grow your own healthy produce? According to the American Farm Bureau Federation’s Fast Facts about Agriculture, farm and ranch families comprise just 2 percent of the U.S. population. (fb.org. 2014)


Lately, there has been several ‘grassroots’ initiatives of urban agriculture in cities such as Detroit, New York City, and even here in Philadelphia. “…The concept of urban agriculture popular provides access to healthy fresh produce, saves money, utilizes abandoned urban areas, and creates a sense of community…” (fao.org. 2015). Kathleen Corr highlighted several such Philadelphia projects in her foodtank.com article. If you live in the Philadelphia area, be sure to check them out.


Moreover, there are several organizations that are willing to either support these efforts, or, they can point you to sources that can assist, if you do not have backyard gardening space. “…Growing Power is a national nonprofit organization and land trust supporting people from diverse backgrounds, and the environments in which they live, by helping to provide equal access to healthy, high-quality, safe and affordable food for people in all communities. Growing Power implements this mission by providing hands-on training, on-the-ground demonstration, outreach and technical assistance through the development of Community Food Systems that help people grow, process, market and distribute food in a sustainable manner…” (“About Growing Power,” 2014). If you are fortunate enough to reside in Baltimore, Md., then there is Baltimore Integration Partnership. It explores food procurement processes in the Baltimore area. (Baltimore Integration Partnership.org, n. d.)


However, if planting a garden does not appeal to you, what are some other viable options to gain access to healthy foods for your family? One option is to demand healthy food in school lunches. “…Improving child nutrition is the focal point of the Healthy, Hunger-Free Kids Act of 2010. The legislation authorizes funding and sets policy for USDA's core child nutrition programs…”


“…The Healthy, Hunger-Free Kids Act allows USDA, for the first time in over 30 years, opportunity to make real reforms to the school lunch and breakfast programs by improving the critical nutrition and hunger safety net for millions of children…” (“Healthy Hunger-Free Kids Act,”2014).


Another option would be to become a food justice advocate. Efforts to level the food quality playing field led Chester, Pa residents to Philabundance and the establishment of a non-profit grocery store.


Non-access to quality food should galvanize each community to urgently seek one or more of the options mentioned to assure safe, healthy access to quality food.


This is just the beginning of the conversation. Please post ideas, and/or tell us about remedies that may have worked in your community. Let’s talk.


As your Fit For You Environmental Health Correspondent, I urge you to send in questions/stories regarding the environmental health issues that confront you on a daily basis in your local area. Please write, and post questions and/or any concerns that you would like to learn more about here. I promise that I will investigate and discuss at my earliest convenience.


Remember: What you don’t know can hurt you, today, or sometime in the future- become informed, knowledge is power!


Sources:


Food Desert. (2010). Retrieved from: http://americannutritionassociation.org/newsletter/usda-defines-food-deserts


Alkon, A. H., Block, D., Moore, K., Gillis, C., DiNuccio, N., & Chavez, N. (2013). Foodways of the urban poor. Geoforum, 48, 126-135.


Fast Facts about Agriculture. (2014). Retrieved January 9, 2015 from: http://www.fb.org/index.php?fuseaction=newsroom.fastfacts


Urban agriculture. (2015). Retrieved January 28, 2015 from: http://www.fao.org/urban-agriculture/en/


Corr, Kathleen. (2014). 10 Exciting Urban Agriculture Projects in Philadelphia. Retrieved January 28, 2015 from: http://foodtank.com/news/2014/01/ten-exciting-urban-agriculture-projects-in-philadelphia


About Growing Power. (2014). Retrieved January 28, 2014 from: http://www.growingpower.org


What is the Baltimore Integration Partnership? (n.d.). Retrieved January 28, 2015 from: http://abagrantmakers.site-ym.com/page/BaltimorePartnership/


Healthy Hunger-Free Kids Act. (2014).Retrieved January 28, 2015 from: http://www.fns.usda.gov/school-meals/healthy-hunger-free-kids-act


Owens, Cassie (2013, October 2). Nation’s First Non-Profit Supermarket Opens in Chester, PA, a Food Desert for 12 Years. Retrieved from: http://nextcity.org/daily/entry/nations-first-non-profit-supermarket-opens-in-chester-pa


When I looked at the World Health Organization’s website under environmental health, here is what I found...


Q: What are the long-term effects of chemicals on children's health, especially lead?


A: Chronic, low-level exposure to various chemicals may result in a number of adverse outcomes. In the case of lead exposure – even at relatively low levels – continuous exposure may have severe effects, such as anaemia, malaise, and damage to the nervous system. Children are particularly vulnerable to the neurotoxic effects of lead. Relatively low levels of exposure can reduce their IQ scores, cause learning disabilities, poor school performance, and violent behaviour, all of which may contribute to reduced lifetime earnings.


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Lead poisoning and health. (2014). Retrieved December 21, 2014 from: http://www.who.int/mediacentre/factsheets/fs379/en/


Q: What are the health risks associated with mobile phones and their base stations?


This is a question which WHO takes very seriously. Given the immense number of people who use mobile phones, even a small increase in the incidence of adverse effects on health could have major public health implications. Because exposure to the radiofrequency (RF) fields emitted by mobile phones is generally more than a 1000 times higher than from base stations, and the greater likelihood of any adverse effect being due to handsets, research has almost exclusively been conducted on possible effects of mobile phone exposure.


Health risks of mobile phones. (2013). What are the health risks associated with mobile phones and their base stations? Retrieved December 21, 2014 from: http://www.who.int/features/qa/30/en/


Q: How can water-related diseases be prevented during emergencies?


The three top priorities concerning drinking water and sanitation during an emergency situation are:

  • ensuring the provision of enough safe water for drinking and for personal hygiene to the people affected by the crisis;
  • ensuring that all people affected by the crisis have access to hygienic sanitation facilities;
  • promoting good hygiene behaviours.


Preventing water-related diseases during emergencies. (2008). Retrieved December 21, 2014 from: http://www.who.int/features/qa/31/en /


The aforementioned are a snippet of some of the issues that each of us is confronted with in our daily lives. However, recently, I had a typical cold: runny nose, sore throat, congestion, and overall, not feeling very well. As a remedy, I used aspirin, lots of hot liquids (such as honey lemon tea), chicken soup, rest, some over the counter (OTC) liquid solutions, and throat lozenges.


After several days, with only limited relief, I consulted my physician, who prescribed an antibiotic. Within 24 hours, I was much better and on the road to a speedy recovery. However, if I had delayed a bit longer following my home remedy, would I have had the same favorable outcome? The answer is –probably.


Do we overuse/abuse antibiotics here in the U.S.? Even to the point of resistance to antibiotics? Let’s examine this a bit further. The following article actually provides an informational handout that clinicians are encouraged to give to their patients when they initially request antibiotics. (Lucas, 2014). Please be sure to download this very informative handout.


Denise Lucas, Denise PhD, RN, CRNP, Jeanne Ann VanFossan, Jeanne Ann VanFossan RN, MSN, MS, CFNP. (2014). When Patients Ask for Antibiotics, Arm Them With Handouts. Retrieved December 21, 2014 from:http://www.clinicianreviews.com/specialty-focus/public-health/article/when-patients-ask-for-antibiotics-arm-them-with-handouts.html


Upon researching further, I located this ten year study that determined that while the reduced the numbers of antibiotics to children, they have not done so in the older populations.


“The use of antibiotics is the single most important driver in antibiotic resistance. Nevertheless, antibiotic overuse remains common…” “…This study describes antibiotic prescribing in the US from 2000 to 2010. Overall, antibiotic use has remained stable; however, there were opposing trends among different age groups. While antibiotic use decreased among children and adolescents, there was no change among adults, and older adults experienced an increase. ..” “…In conclusion, overall antibiotic use has decreased among children and adolescents, but has increased among older adults. Broad-spectrum antibiotic prescribing has increased among all age ranges. Acute respiratory tract infection (ARTI) visits have declined; however, patients who present for ARTI visits are more likely to receive an antibiotic than in the past. Our study highlights the persistent problem of antibiotic overuse. Public policy initiatives to promote the judicious use of antibiotics should continue and programs targeting older adults should be developed…”


Lee, G. C., Reveles, K. R., Attridge, R. T., Lawson, K. A., Mansi, I. A., Lewis, J. S., & Frei, C. R. (2014). Outpatient antibiotic prescribing in the United States: 2000 to 2010. BMC Medicine, 12, 96. doi:10.1186/1741-7015-12-96


Interestingly enough, I experienced an adverse reaction to broad–spectrum antibiotics when I was treated for mycoplasma pneumonia/ “walking pneumonia”, which required years of probiotic supplements to undo. “Walking pneumonia is an informal term for pneumonia that isn't severe enough to require bed rest or hospitalization. You may feel like you have a cold. The symptoms are generally so mild that you don't feel you need to stay home from work or school, so you are out walking around…”


What is walking pneumonia? How is it different from regular pneumonia?


Rosenow III, MD, Edward, C. (2014). What is walking pneumonia? How is it different from regular pneumonia? Retrieved December 21, 2014 from: http://www.mayoclinic.org/diseases-conditions/pneumonia/expert-answers/walking-pneumonia/faq-20058530


As your Fit For You Environmental Health Correspondent, I urge you to send in questions/stories regarding the environmental health issues that confront you on a daily basis in your local area. Please write, and post questions and/or any concerns that you would like to learn more about here. I promise that I will investigate and discuss at my earliest convenience.


Remember: What you don’t know can hurt you, today, or sometime in the future- become informed, knowledge is power!


Bibliography:


Lead poisoning and health. (2014). Retrieved December 21, 2014 from: http://www.who.int/mediacentre/factsheets/fs379/en/


Health risks of mobile phones. (2013). What are the health risks associated with mobile phones and their base stations? Retrieved December 21, 2014 from: http://www.who.int/features/qa/30/en/


Preventing water-related diseases during emergencies. (2008). Retrieved December 21, 2014 from: http://www.who.int/features/qa/31/en/


Denise Lucas, Denise PhD, RN, CRNP, Jeanne Ann VanFossan, Jeanne Ann VanFossan RN, MSN, MS, CFNP. (2014). When Patients Ask for Antibiotics, Arm Them With Handouts. Retrieved December 21, 2014 from:http://www.clinicianreviews.com/specialty-focus/public-health/article/when-patients-ask-for-antibiotics-arm-them-with-handouts.html


Lee, G. C., Reveles, K. R., Attridge, R. T., Lawson, K. A., Mansi, I. A., Lewis, J. S., & Frei, C. R. (2014). Outpatient antibiotic prescribing in the United States: 2000 to 2010. BMC Medicine, 12, 96. doi:10.1186/1741-7015-12-96


Rosenow III, MD, Edward, C. (2014). What is walking pneumonia? How is it different from regular pneumonia? Retrieved December 21, 2014 from: http://www.mayoclinic.org/diseases-conditions/pneumonia/expert-answers/walking-pneumonia/faq-20058530


The environment is all around us, affecting our lives every moment. The media are replete with examples of how changes in the environment expose us to health risks.n, fitness, weight-loss, stress relief and self improvement.


If you were living in the United States in June 2012, you would have heard warnings to stay indoors. According to the National Oceanic and Atmospheric Administration (NOAA), in 2012, the United States experienced the warmest spring and the second warmest May on record. On June 24, 2012, Austin, Dallas-Fort Worth, Denver, Fort Collins, and Greeley were rated as the cities to have the highest Air Quality Indices (AQIs)—a measure of daily air quality. The AQI of these cities ranged from 101 to 150, which is considered unhealthy for sensitive groups (the elderly and people with chronic health problems, such as lung and heart diseases). (noaa.gov,2012)What is Your Air Quality IQ? (noaa.gov,2012) AQI can range from 1 to 500. Anything above 100 is unhealthy to hazardous-The higher the number, the worse the air quality. (Airnow.gov).


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How does a high AQI impact the environment?


Occurrences of high AQIs may lead to increased wildfires, which, in turn, may result in deforestation and impaired outdoor air quality. Health threats from wildfires can include skin burns and carbon monoxide poisoning. Exposure to smoke can cause eye and nose irritation and respiratory illnesses, such as bronchitis. Deforestation not only increases the spread of certain diseases, such as malaria and Lyme disease; but also destroys useful plants and animals, disturbing the ecosystem and the overall environmental health.


The Healthy People Consortium, an alliance of 350 national organizations and 250 state agencies, developed the Healthy People goals and objectives ("Introduction," n.d.). Its goal is to promote health for all through a healthy environment meeting specific environmental health objectives.


However, The Healthy People Consortium has a new initiative which looks at the social determinants of health “…Health starts in our homes, schools, workplaces, neighborhoods, and communities. We know that taking care of ourselves by eating well and staying active, not smoking, getting the recommended immunizations and screening tests, and seeing a doctor when we are sick all influence our health. Our health is also determined in part by access to social and economic opportunities; the resources and supports available in our homes, neighborhoods, and communities; the quality of our schooling; the safety of our workplaces; the cleanliness of our water, food, and air; and the nature of our social interactions and relationships. The conditions in which we live explain in part why some Americans are healthier than others and why Americans more generally are not as healthy as they could be…” (healthypeople.gov)


What are Social determinants of health?


“…Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Conditions (e.g., social, economic, and physical) in these various environments and settings (e.g., school, church, workplace, and neighborhood) have been referred to as “place.” In addition to the more material attributes of “place,” the patterns of social engagement and sense of security and well-being are also affected by where people live. Resources that enhance quality of life can have a significant influence on population health outcomes. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins.


Understanding the relationship between how population groups experience “place” and the impact of “place” on health is fundamental to the social determinants of health—including both social and physical determinants…”


As your Fit For You Environmental Health Correspondent, I am very interested in hearing about the environmental health issues that confront you on a daily basis in your local area. Please write, and post questions and/or any concerns that you would like to learn more about here. I promise that I will investigate and discuss at my earliest convenience.


Remember: What you don’t know can hurt you, today, or sometime in the future- become informed, knowledge is power!


Bibliography:


National Weather Service. Retrieved from: http://www.nws.noaa.gov/airquality Air Quality Index (AQI) - A Guide to Air Quality and Your Health. (2014). Retrieved December 21,, 2014 from: http://airnow.gov/index.cfm?action=aqibasics.aqi


Social Determinants of Health. Retrieved December 21, 2014 from: https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health Disparities in Health Care: Methods for Studying the Effects of Race, Ethnicity, and SES on Access, Use, and Quality of health care. (2002). Retrieved December 21, 2014 from: http://www.iom.edu/~/media/Files/Activity%20Files/Quality/NHDRGuidance/DisparitiesGornick.pdf

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